Nearly 20 years ago, I finished medical school and started my training as a neurosurgeon. Since then, I have been fascinated with a ritual-laden, somewhat secretive meeting that takes place in hospitals all over the country. It is known as “Death and Complications” or “Morbidity and Mortality,” and it is one of the most dramatic and indelible meetings a doctor will ever attend. At this insiders-only gathering, doctors openly discuss their mistakes, complications, and yes—deaths. From a practical standpoint, the meeting is sort of a quality-assurance mechanism to allow surgeons to police themselves and even debate clinical gray zones, but the stories were the most riveting I had ever heard.
Over the years, I have observed many of these gatherings and one thing was constant—the discussion of mistakes is tremendously unsettling, even for the most seasoned surgeons. There is, however, a spectrum of surgical personalities, from the forthright and the blunt to tentative and even evasive. Many surgeons are quick to blame anesthesia or any specialty other than their own. Other surgeons are born entertainers, using showmanship and black humor to distract their colleagues. Many times, I have seen the meeting turn into a battle zone, with surgeons picking sides and forging alliances.
I would often jot down notes after these meetings to remember the important teaching points that can result from a medical mistake, but few years ago, I realized something else when re-reading my old notepads. There was a remarkable narrative that had emerged, and it was a story that had never been told.
In Monday Mornings, I decided to give readers an honest, transparent and sometimes raw peek behind the curtain at one of the most hallowed traditions in medicine. There are five main characters that are all composites of people I have met over the last two decades, and they represent both important lessons about medicine and also the convergence between humanity and healing.
This is a story about Chelsea General, a fictitious hospital where some of the greatest surgeons have honed their skills. Sometimes the path to greatness is a little messy. Some surgeons emerge stronger than ever, and others are crushed, never fully re-engaging in the practice of medicine. The real story behind these surgeons begins at those secret gatherings on Monday mornings.